Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.94 / $239.94 / $239.94	Facility		$239.94	$239.94	$239.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.15 / $239.94 / $272.27	Professional		$205.15	$239.94	$272.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $420.15 / $420.15 / $420.15	Facility		$420.15	$420.15	$420.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $399.14 / $420.15 / $567.20	Professional		$399.14	$420.15	$567.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $273.10 / $273.10 / $285.27	Facility		$273.10	$273.10	$285.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $336.12 / $336.12 / $336.12	Professional		$336.12	$336.12	$336.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $373.38 / $373.38 / $373.38	Facility		$373.38	$373.38	$373.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.37 / $349.34 / $540.71	Professional		$317.37	$349.34	$540.71
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $239.94 / $303.61 / $303.61	Facility		$239.94	$303.61	$303.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $239.94 / $303.61 / $504.18	Professional		$239.94	$303.61	$504.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $174.67 / $209.60 / $322.99	Professional		$174.67	$209.60	$322.99